The pathophysiological mechanisms of tendinopathies integrate various intrinsic and extrinsic factors. Classic «passive» therapeutics have a limited action. Because of a better pathophysiological ... [more ▼]

The pathophysiological mechanisms of tendinopathies integrate various intrinsic and extrinsic factors. Classic «passive» therapeutics have a limited action. Because of a better pathophysiological understanding of tendinopathies, more recent treatments (injections of various compounds, infiltrations of platelet-rich plasma, stem cells) would lead to a longterm healing. In case of failure of conservative managements and depending on the anatomical site, a surgical approach may be considered. [less ▲]

in The Journal of sports medicine and physical fitness (2015), 55(9), 953-61

INTRODUCTION: Jumper's knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons ... [more ▼]

INTRODUCTION: Jumper's knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons. METHODS: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10--point Visual Analogic Scale, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA--P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a standardised sub--maximal eccentric reeducation. RESULTS: Pain during daily activities significantly decreased with time. During functional evaluation, it decreased as well, but without significant functional improvement. No improvements in the imagery measurements were observed. Younger patients seemed to be more susceptible to have an improvement of pain by the PRP infiltration. CONCLUSION: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol can improve symptoms of chronic jumper's knee in patients non--responsive to classical conservative treatments. [less ▲]

Introduction: The Victorian Institute of Sports Assessment–Patellar (VISA-P), originally developed for English-speaking patients, assesses the severity of patellar tendinopathy symptoms. Although this ... [more ▼]

Introduction: The Victorian Institute of Sports Assessment–Patellar (VISA-P), originally developed for English-speaking patients, assesses the severity of patellar tendinopathy symptoms. Although this questionnaire has already been translated into different languages, it has never been adapted for French-speaking patients, which is surprising. Indeed, French is not only spoken by most than 275 millions of people all around the world. The aim of our study was to validate a French version and verify its psychometric properties. Materials and Methods: The translation and cultural adaptation were performed according to international recommendations in six steps: initial translation, translation merging, back translation to the original language, expert committee review to test the pre-final version, and expert committee appraisal. Once the final French version (VISA-PF) was obtained, certain psychometric properties were assessed in 92 subjects were included and divided into three groups: pathological subjects (n = 28), asymptomatic subjects (n = 22) and sports-risk subjects (n = 42). Results: The different members of the expert committee agreed with the final version. The average scores of the VISA-PF obtained were 53 (± 17) for the pathological group, 99 (± 2) for the healthy group and 86 (± 14) for the sports-risk group. The test-retest reliability of the VISA-PF was excellent with an intra-class correlation coefficient of 0.99 and good internal consistency (α = 0.9). Correlations between the VISA-PF and diverging measures of the SF-36 were low and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion: The VISA-PF is understandable, reliable and suitable for French-speaking patients with patellar tendinopathy. [less ▲]

Introduction : The Victorian Institute of Sports Assessment– Achilles (VISA-A) was designed to evaluate the clinical severity of Achilles tendinopathy. It has been developed in English and therefore is ... [more ▼]

Introduction : The Victorian Institute of Sports Assessment– Achilles (VISA-A) was designed to evaluate the clinical severity of Achilles tendinopathy. It has been developed in English and therefore is not adapted for French-speaking patients. Although this questionnaire has already been translated into different languages but not in French. French is spoken by most than 275 millions of people and is one of the 2 official languages of the International Olympic Committee, and one of the 6 official languages and one of the 2 working languages of the United Nation Organisation. The aim of this study was to translate this questionnaires into French and to study its reliability and validity. Methods : The questionnaire was translated into French (VISA-AF) according to the "guidelines for the process of cross-cultural adaptation of self-report measures" using six steps: translation, synthesis, back translation, expert committee review, pretesting, and appraisal of the adaptation process by the expert committee. Once the final versions obtained, several psychometric proprieties such as test-retest fidelity, internal coherence, construct validity and floor and ceiling effects were evaluated. We recruited 116 subjects who were distributed in 3 groups: pathological patients (n=31), at risk athletes (n=63), healthy people (n=22). Results : The questionnaire was approved by the expert committee after the pre-final version test. On a scale ranging from 0 (theoretical minimum) to 100 (asymptomatic subject), the average scores of the VISA-PF obtained were 59 (± 18) for the pathological group, 99 (± 1) for the healthy group and 94 (± 7) for the sports-risk group. The VISA-A-F shows excellent reliability. The VISA-AF shows low correlations with the divergent sub-scales of the SF-36 and moderate correlations with the convergent sub-scales of the SF-36. No floor and ceiling effects were detected during the evaluation of the two questionnaires. Conclusion : The French versions of the VISA-A is equivalent to its original version and is reliable and valid questionnaire for French speaking patients with Achilles tendinopathy. [less ▲]

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative ... [more ▼]

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of 2 or 3 successive infiltrations. The aim of this study was to evaluate whether 2 infiltrations of PRP proves more effective than a single treatment. Material and methods: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (1 or 2 infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. Discussion and conclusion: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups at short to mid term. A second closely-timed infiltration of PRP to treat chronic proximal patellar tendinopathy is not necessary to improve the efficacy of this treatment in the short term. [less ▲]

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the ... [more ▼]

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the return to sports activities in patients with chronic upper patellar tendinopathies. Material and methods : Twenty subjects with chronic upper patellar tendinopathy benefited from 1 infiltration of PRP. The follow-up (up to 1 year) was assessed by means of a Visual Anologue Scale (VAS), the International Knee Documentation Committee (IKDC) form and the Victorian Institute of Sport Assessment (VISA-P) score. Moreover, subjects had to answer an information questionnaire concerning their life and sports activities. Results : Seventy percents of the patients reported a favourable evolution with decrease of pain, and returned to sports activities. With time, VAS dropped significantly and both IKDC and VISA-P scores improved also significantly. Conclusion : This study confirms that a local injection of PRP coupled with a program of eccentric rehabilitation for treating a chronic jumper's knee, improves pain symptoms and the functionalities of the subjects’ knee up to 1 year after injection. [less ▲]

Overhead athletes are more at risk of suffering shoulder injuries or/and developing shoulder pain. Stretching programs have been shown to successfully reduce pain for this population. However no study has ... [more ▼]

Overhead athletes are more at risk of suffering shoulder injuries or/and developing shoulder pain. Stretching programs have been shown to successfully reduce pain for this population. However no study has provided a global overview of the effects of stretching. The present study evaluated the evolution of the pain, the strength of the shoulder muscles, potential instabilities or lesion of the shoulder as well as the 3D scapular kinematics of 10 overhead athletes having a painful and stiff dominant shoulder. Our results show a significant decrease of the pain and of the positive impingement syndrome tests. The kinematics of the scapula reveals a more upward rotation of the scapula after the stretching, which may reduce the risk of sub-acromial conflicts. The strength of the internal and external rotators of the shoulder is not modified by the program. [less ▲]

The serve is an important stroke in any high level tennis game. A well-mastered serve is a substantial advantage for players. However, because of its repeatability and its intensity, this stroke is ... [more ▼]

The serve is an important stroke in any high level tennis game. A well-mastered serve is a substantial advantage for players. However, because of its repeatability and its intensity, this stroke is potentially deleterious for upper limbs, lower limbs and trunk. The trunk is a vital link in the production and transfer of energy from the lower limbs to the upper limbs; therefore, kin-ematic disorder could be a potential source of risk for trunk injury in tennis. This research studies the case of a professional tennis player who has suffered from a medical tear on the left rectus abdominis muscle after tennis serve. The goal of the study is to understand whether the injury could be explained by an inappropriate technique. For this purpose, we analyzed in three dimensions the kinematic and kinetic aspects of the serve. We also performed isokinetic tests of the player’s knees. We then compared the player to five other professional players as refer-ence. We observed a possible deficit of energy transfer because of an important anterior pelvis tilt. Some compensation made by the player during the serve could be a possible higher abdominal contraction and a larger shoulder external rotation. These partic-ularities could induce an abdominal overwork that could explain the first injury and may provoke further injuries. [less ▲]

This research studies the case of a professional tennis player who has suffered from a medical tear on the left rectus abdominis muscle after a tennis serve. The goal of the study is to understand whether ... [more ▼]

This research studies the case of a professional tennis player who has suffered from a medical tear on the left rectus abdominis muscle after a tennis serve. The goal of the study is to understand whether the injury could be explained by an inappropriate technique. For this purpose, we analyzed the three dimensions kinematic and kinetic of the serve. We also performed isokinetic tests of the knees. We compared the player to five other professional players. We observed a possible deficit of energy transfer because of an important anterior pelvis tilt. Some compensations of the player during serve could be a possible higher abdominal contraction and a larger shoulder external rotation. These particularities could induce an abdominal overwork that would explain the first injury and may provoke a new injury. [less ▲]

Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the return to sports ... [more ▼]

Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the return to sports activities in patients with chronic proximal patellar tendinopathies. Twenty subjects with chronic proximal patellar tendinopathy benefited from 1 infiltration of PRP coupled with a standardized eccentric rehabilitation. The follow-up (up to 1 year) was assessed by means of a Visual Anologue Scale (VAS), the International Knee Documentation Committee (IKDC) form and the Victorian Institute of Sport Assessment (VISA-P) score. Moreover, subjects had to answer an information questionnaire concerning their life and sports activities. Seventy percents of the patients reported a favourable evolution with decrease of pain, and returned to sports activities. With time, VAS dropped significantly and both IKDC and VISA-P scores improved also significantly. This study confirms that a local injection of PRP coupled with a program of eccentric rehabilitation for treating a chronic jumper’s knee, improves pain symptoms and the functionaliti [less ▲]

in Radmann, A; Hedenborg, S; Tsolakidis, E (Eds.) 20th annual Congress of the EUROPEAN COLLEGE OF SPORT SCIENCE - BOOK OF ABSTRACTS (2015, June)

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of jumper’s knee. Although it is possible that a single infiltrative administration may prove to ... [more ▼]

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of jumper’s knee. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of 2 or 3 successive infiltrations. The aim of this study was to evaluate whether 2 infiltrations of PRP proves moreeffective than a single treatment. Methods: Twenty patients suffering from chronic jumper’s knee were enrolled into our prospective, randomized and comparative study of level 2, and split into two randomized groups (1 or 2 infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups.Discussion: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups at short to mid term. A second closely-timed infiltration of PRP to treat jumper’s knees is not necessary to improve the efficacy of this treatment in the short term. References: Kaux JF, Croisier JL, Bruyere O, Rodriguez de la Cruz C, Forthomme B, Brabant G et al. One injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper’s knee. J Sports Med Phys Fitness. 2014 Jun 19. [Epub ahead of print]. Kaux JF, Croisier JL, Forthomme B, Le Goff C, Buhler F, Savanier C et al. Using platelet-rich plasma to treat jumper’s knees: exploring the effect of a second closely-timed infiltration. J Sci Med Sport. Submitted. Kaux JF, Bruyère O, Croisier JL, Forthomme N, Le Goff C, Rohr N et al. One-year follow-up of platelet-rich plasma infiltration to treat chronic upper patellar tendinopathies. Acta Orthop Belg. In press. [less ▲]